Prophylaxis (D1110), Scaling with Moderate/Severe Gingival Inflammation (D4346)
D1110: Preventive or therapeutic procedure for removal of plaque, calculus, and stain from the exposed and unexposed surfaces of the teeth by scaling and polishing as a preventative measure for the control of local irritants (Glossary of Periodontal Terms; 4th Edition, 2001).
D4346: Therapeutic procedure for removal of plaque, calculus, and stains from supra- and subgingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis/bone loss.
Scaling & Root Planing (D4341), Limited Scaling & Root Planing (D4342)
Instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus, as well as removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated with toxins or microorganisms. For patient comfort, deeper insertion of instrumentation, and hemostasis, anesthesia should be used used unless explicitly refused by the patient.
Re-evaluation/Initial Treatment Evaluation (D0180P)
Evaluation 4-6 weeks after initial therapy to determine the effectiveness of treatment and review proficiency of home care. While 4-8 weeks is considered acceptable, failure to re-evaluate periodontal patients is a failure to practice within the standard of care. Re-evaluation includes examination of bleeding on probing, probing depths, clinical attachment levels, pathologic tooth mobility, furcation involvement, assessment of local factors, plaque index, review of oral hygiene, and reinstrumentation if needed. (Journal of Periodontology, 77, 2006).
Supportive Periodontal Therapy (D4910)
This procedure is instituted following active periodontal therapy and continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition or any implant replacements. Maintenance procedures are under the supervision of the dentist and typically include an update of the medical and dental histories, radiographic review, extraoral and intraoral soft tissue examination, dental examination, periodontal evaluation, removal of the bacterial flora from crevicular and pocket areas, scaling and root planing where indicated, polishing of teeth, and a review of the patient’s plaque control efficacy.